IBDEI07X ; ; 01-AUG-2022
;;3.0;IB ENCOUNTER FORM IMP/EXP;;AUG 01, 2022
Q:'DIFQR(358.3) F I=1:2 S X=$T(Q+I) Q:X="" S Y=$E($T(Q+I+1),4,999),X=$E(X,4,999) S:$A(Y)=126 I=I+1,Y=$E(Y,2,999)_$E($T(Q+I+1),5,999) S:$A(Y)=61 Y=$E(Y,2,999) X NO E S @X=Y
Q Q
;;^UTILITY(U,$J,358.3,19300,0)
;;=99080^^64^789^38^^^^1
;;^UTILITY(U,$J,358.3,19300,1,0)
;;=^358.31IA^3^2
;;^UTILITY(U,$J,358.3,19300,1,2,0)
;;=2^Special Reports or Forms
;;^UTILITY(U,$J,358.3,19300,1,3,0)
;;=3^99080
;;^UTILITY(U,$J,358.3,19301,0)
;;=29105^^64^789^3^^^^1
;;^UTILITY(U,$J,358.3,19301,1,0)
;;=^358.31IA^3^2
;;^UTILITY(U,$J,358.3,19301,1,2,0)
;;=2^Apply Long Arm Splint,Static
;;^UTILITY(U,$J,358.3,19301,1,3,0)
;;=3^29105
;;^UTILITY(U,$J,358.3,19302,0)
;;=29125^^64^789^6^^^^1
;;^UTILITY(U,$J,358.3,19302,1,0)
;;=^358.31IA^3^2
;;^UTILITY(U,$J,358.3,19302,1,2,0)
;;=2^Apply Short Arm Splint,Static
;;^UTILITY(U,$J,358.3,19302,1,3,0)
;;=3^29125
;;^UTILITY(U,$J,358.3,19303,0)
;;=29126^^64^789^5^^^^1
;;^UTILITY(U,$J,358.3,19303,1,0)
;;=^358.31IA^3^2
;;^UTILITY(U,$J,358.3,19303,1,2,0)
;;=2^Apply Short Arm Splint,Dynamic
;;^UTILITY(U,$J,358.3,19303,1,3,0)
;;=3^29126
;;^UTILITY(U,$J,358.3,19304,0)
;;=29130^^64^789^2^^^^1
;;^UTILITY(U,$J,358.3,19304,1,0)
;;=^358.31IA^3^2
;;^UTILITY(U,$J,358.3,19304,1,2,0)
;;=2^Apply Finger Splint,Static
;;^UTILITY(U,$J,358.3,19304,1,3,0)
;;=3^29130
;;^UTILITY(U,$J,358.3,19305,0)
;;=29131^^64^789^1^^^^1
;;^UTILITY(U,$J,358.3,19305,1,0)
;;=^358.31IA^3^2
;;^UTILITY(U,$J,358.3,19305,1,2,0)
;;=2^Apply Finger Splint,Dynamic
;;^UTILITY(U,$J,358.3,19305,1,3,0)
;;=3^29131
;;^UTILITY(U,$J,358.3,19306,0)
;;=S9451^^64^789^19^^^^1
;;^UTILITY(U,$J,358.3,19306,1,0)
;;=^358.31IA^3^2
;;^UTILITY(U,$J,358.3,19306,1,2,0)
;;=2^Exercise Class per Session
;;^UTILITY(U,$J,358.3,19306,1,3,0)
;;=3^S9451
;;^UTILITY(U,$J,358.3,19307,0)
;;=97129^^64^789^45^^^^1
;;^UTILITY(U,$J,358.3,19307,1,0)
;;=^358.31IA^3^2
;;^UTILITY(U,$J,358.3,19307,1,2,0)
;;=2^Therapy Intrvn Cognitive Func,1st 15 min
;;^UTILITY(U,$J,358.3,19307,1,3,0)
;;=3^97129
;;^UTILITY(U,$J,358.3,19308,0)
;;=97130^^64^789^46^^^^1
;;^UTILITY(U,$J,358.3,19308,1,0)
;;=^358.31IA^3^2
;;^UTILITY(U,$J,358.3,19308,1,2,0)
;;=2^Therapy Intrvn Cognitive Func,Ea Addl 15 min
;;^UTILITY(U,$J,358.3,19308,1,3,0)
;;=3^97130
;;^UTILITY(U,$J,358.3,19309,0)
;;=90912^^64^789^9^^^^1
;;^UTILITY(U,$J,358.3,19309,1,0)
;;=^358.31IA^3^2
;;^UTILITY(U,$J,358.3,19309,1,2,0)
;;=2^Biofdbk Trng Peri/Uro/Rectal,1st 15 min
;;^UTILITY(U,$J,358.3,19309,1,3,0)
;;=3^90912
;;^UTILITY(U,$J,358.3,19310,0)
;;=90913^^64^789^10^^^^1
;;^UTILITY(U,$J,358.3,19310,1,0)
;;=^358.31IA^3^2
;;^UTILITY(U,$J,358.3,19310,1,2,0)
;;=2^Biofdbk Trng Peri/Uro/Rectal,Ea Addl 15 min
;;^UTILITY(U,$J,358.3,19310,1,3,0)
;;=3^90913
;;^UTILITY(U,$J,358.3,19311,0)
;;=S06.0X1A^^65^790^1
;;^UTILITY(U,$J,358.3,19311,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19311,1,3,0)
;;=3^Concussion w LOC of 30 minutes or less, init
;;^UTILITY(U,$J,358.3,19311,1,4,0)
;;=4^S06.0X1A
;;^UTILITY(U,$J,358.3,19311,2)
;;=^5020669
;;^UTILITY(U,$J,358.3,19312,0)
;;=S06.0X9A^^65^790^2
;;^UTILITY(U,$J,358.3,19312,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19312,1,3,0)
;;=3^Concussion w LOC of unsp duration, init
;;^UTILITY(U,$J,358.3,19312,1,4,0)
;;=4^S06.0X9A
;;^UTILITY(U,$J,358.3,19312,2)
;;=^5020693
;;^UTILITY(U,$J,358.3,19313,0)
;;=S06.0X0A^^65^790^3
;;^UTILITY(U,$J,358.3,19313,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19313,1,3,0)
;;=3^Concussion w/o LOC, initial encounter
;;^UTILITY(U,$J,358.3,19313,1,4,0)
;;=4^S06.0X0A
;;^UTILITY(U,$J,358.3,19313,2)
;;=^5020666
;;^UTILITY(U,$J,358.3,19314,0)
;;=Z13.850^^65^790^14
;;^UTILITY(U,$J,358.3,19314,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19314,1,3,0)
;;=3^TBI Screening
;;^UTILITY(U,$J,358.3,19314,1,4,0)
;;=4^Z13.850
;;^UTILITY(U,$J,358.3,19314,2)
;;=^5062717
;;^UTILITY(U,$J,358.3,19315,0)
;;=Z87.820^^65^790^13
;;^UTILITY(U,$J,358.3,19315,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19315,1,3,0)
;;=3^Personal history of traumatic brain injury
;;^UTILITY(U,$J,358.3,19315,1,4,0)
;;=4^Z87.820
;;^UTILITY(U,$J,358.3,19315,2)
;;=^5063514
;;^UTILITY(U,$J,358.3,19316,0)
;;=S06.890A^^65^790^11
;;^UTILITY(U,$J,358.3,19316,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19316,1,3,0)
;;=3^Intcrn inj w/o LOC, init encntr
;;^UTILITY(U,$J,358.3,19316,1,4,0)
;;=4^S06.890A
;;^UTILITY(U,$J,358.3,19316,2)
;;=^5021176
;;^UTILITY(U,$J,358.3,19317,0)
;;=S06.1X5A^^65^790^15
;;^UTILITY(U,$J,358.3,19317,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19317,1,3,0)
;;=3^Traumatic cerebral edema w LOC >24 hr w ret consc lev, init
;;^UTILITY(U,$J,358.3,19317,1,4,0)
;;=4^S06.1X5A
;;^UTILITY(U,$J,358.3,19317,2)
;;=^5020711
;;^UTILITY(U,$J,358.3,19318,0)
;;=S06.1X6A^^65^790^16
;;^UTILITY(U,$J,358.3,19318,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19318,1,3,0)
;;=3^Traumatic cerebral edema w LOC >24 hr w/o ret consc w surv, init
;;^UTILITY(U,$J,358.3,19318,1,4,0)
;;=4^S06.1X6A
;;^UTILITY(U,$J,358.3,19318,2)
;;=^5020714
;;^UTILITY(U,$J,358.3,19319,0)
;;=S06.1X3A^^65^790^17
;;^UTILITY(U,$J,358.3,19319,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19319,1,3,0)
;;=3^Traumatic cerebral edema w LOC of 1-5 hrs 59 min, init
;;^UTILITY(U,$J,358.3,19319,1,4,0)
;;=4^S06.1X3A
;;^UTILITY(U,$J,358.3,19319,2)
;;=^5020705
;;^UTILITY(U,$J,358.3,19320,0)
;;=S06.1X1A^^65^790^18
;;^UTILITY(U,$J,358.3,19320,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19320,1,3,0)
;;=3^Traumatic cerebral edema w LOC of 30 minutes or less, init
;;^UTILITY(U,$J,358.3,19320,1,4,0)
;;=4^S06.1X1A
;;^UTILITY(U,$J,358.3,19320,2)
;;=^5020699
;;^UTILITY(U,$J,358.3,19321,0)
;;=S06.1X2A^^65^790^19
;;^UTILITY(U,$J,358.3,19321,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19321,1,3,0)
;;=3^Traumatic cerebral edema w LOC of 31-59 min, init
;;^UTILITY(U,$J,358.3,19321,1,4,0)
;;=4^S06.1X2A
;;^UTILITY(U,$J,358.3,19321,2)
;;=^5020702
;;^UTILITY(U,$J,358.3,19322,0)
;;=S06.1X4A^^65^790^20
;;^UTILITY(U,$J,358.3,19322,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19322,1,3,0)
;;=3^Traumatic cerebral edema w LOC of 6 hours to 24 hours, init
;;^UTILITY(U,$J,358.3,19322,1,4,0)
;;=4^S06.1X4A
;;^UTILITY(U,$J,358.3,19322,2)
;;=^5020708
;;^UTILITY(U,$J,358.3,19323,0)
;;=S06.1X7A^^65^790^22
;;^UTILITY(U,$J,358.3,19323,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19323,1,3,0)
;;=3^Traumatic cerebral edema w LOC w death d/t brain inj bf consc, init
;;^UTILITY(U,$J,358.3,19323,1,4,0)
;;=4^S06.1X7A
;;^UTILITY(U,$J,358.3,19323,2)
;;=^5020717
;;^UTILITY(U,$J,358.3,19324,0)
;;=S06.1X8A^^65^790^23
;;^UTILITY(U,$J,358.3,19324,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19324,1,3,0)
;;=3^Traumatic cerebral edema w LOC w death d/t oth cause bf consc, init
;;^UTILITY(U,$J,358.3,19324,1,4,0)
;;=4^S06.1X8A
;;^UTILITY(U,$J,358.3,19324,2)
;;=^5020720
;;^UTILITY(U,$J,358.3,19325,0)
;;=S06.1X9A^^65^790^21
;;^UTILITY(U,$J,358.3,19325,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19325,1,3,0)
;;=3^Traumatic cerebral edema w LOC of unsp duration, init
;;^UTILITY(U,$J,358.3,19325,1,4,0)
;;=4^S06.1X9A
;;^UTILITY(U,$J,358.3,19325,2)
;;=^5020723
;;^UTILITY(U,$J,358.3,19326,0)
;;=S06.1X0A^^65^790^24
;;^UTILITY(U,$J,358.3,19326,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19326,1,3,0)
;;=3^Traumatic cerebral edema w/o LOC, init
;;^UTILITY(U,$J,358.3,19326,1,4,0)
;;=4^S06.1X0A
;;^UTILITY(U,$J,358.3,19326,2)
;;=^5020696
;;^UTILITY(U,$J,358.3,19327,0)
;;=S06.9X5A^^65^790^4
;;^UTILITY(U,$J,358.3,19327,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19327,1,3,0)
;;=3^Intcrn inj w LOC >24 hr w ret consc lev, init encntr,Unspec
;;^UTILITY(U,$J,358.3,19327,1,4,0)
;;=4^S06.9X5A
;;^UTILITY(U,$J,358.3,19327,2)
;;=^5021221
;;^UTILITY(U,$J,358.3,19328,0)
;;=S06.9X6A^^65^790^5
;;^UTILITY(U,$J,358.3,19328,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19328,1,3,0)
;;=3^Intcrn inj w LOC >24 hr w/o ret consc w surv, init encntr,Unspec
;;^UTILITY(U,$J,358.3,19328,1,4,0)
;;=4^S06.9X6A
;;^UTILITY(U,$J,358.3,19328,2)
;;=^5021224
;;^UTILITY(U,$J,358.3,19329,0)
;;=S06.9X3A^^65^790^6
;;^UTILITY(U,$J,358.3,19329,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19329,1,3,0)
;;=3^Intcrn inj w LOC of 1-5 hrs 59 min, init encntr,Unspec
;;^UTILITY(U,$J,358.3,19329,1,4,0)
;;=4^S06.9X3A
;;^UTILITY(U,$J,358.3,19329,2)
;;=^5021215
;;^UTILITY(U,$J,358.3,19330,0)
;;=S06.9X1A^^65^790^7
;;^UTILITY(U,$J,358.3,19330,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19330,1,3,0)
;;=3^Intcrn inj w LOC of 30 minutes or less, init encntr,Unspec
;;^UTILITY(U,$J,358.3,19330,1,4,0)
;;=4^S06.9X1A
;;^UTILITY(U,$J,358.3,19330,2)
;;=^5021209
;;^UTILITY(U,$J,358.3,19331,0)
;;=S06.9X2A^^65^790^8
;;^UTILITY(U,$J,358.3,19331,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19331,1,3,0)
;;=3^Intcrn inj w LOC of 31-59 min, init encntr,Unspec
;;^UTILITY(U,$J,358.3,19331,1,4,0)
;;=4^S06.9X2A
;;^UTILITY(U,$J,358.3,19331,2)
;;=^5021212
;;^UTILITY(U,$J,358.3,19332,0)
;;=S06.9X4A^^65^790^9
;;^UTILITY(U,$J,358.3,19332,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19332,1,3,0)
;;=3^Intcrn inj w LOC of 6 hours to 24 hours, init encntr,Unspec
;;^UTILITY(U,$J,358.3,19332,1,4,0)
;;=4^S06.9X4A
;;^UTILITY(U,$J,358.3,19332,2)
;;=^5021218
;;^UTILITY(U,$J,358.3,19333,0)
;;=S06.9X9A^^65^790^10
;;^UTILITY(U,$J,358.3,19333,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19333,1,3,0)
;;=3^Intcrn inj w LOC of unsp duration, init encntr,Unspec
;;^UTILITY(U,$J,358.3,19333,1,4,0)
;;=4^S06.9X9A
;;^UTILITY(U,$J,358.3,19333,2)
;;=^5021233
;;^UTILITY(U,$J,358.3,19334,0)
;;=S06.9X0A^^65^790^12
;;^UTILITY(U,$J,358.3,19334,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19334,1,3,0)
;;=3^Intcrn inj w/o LOC, init encntr,Unspec
;;^UTILITY(U,$J,358.3,19334,1,4,0)
;;=4^S06.9X0A
;;^UTILITY(U,$J,358.3,19334,2)
;;=^5021206
;;^UTILITY(U,$J,358.3,19335,0)
;;=S78.019S^^65^791^4
;;^UTILITY(U,$J,358.3,19335,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19335,1,3,0)
;;=3^Complete traumatic amputation at unsp hip joint, sequela
;;^UTILITY(U,$J,358.3,19335,1,4,0)
;;=4^S78.019S
;;^UTILITY(U,$J,358.3,19335,2)
;;=^5039710
;;^UTILITY(U,$J,358.3,19336,0)
;;=S68.419S^^65^791^1
;;^UTILITY(U,$J,358.3,19336,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19336,1,3,0)
;;=3^Complete traumatic amp of unsp hand at wrist level, sequela
;;^UTILITY(U,$J,358.3,19336,1,4,0)
;;=4^S68.419S
;;^UTILITY(U,$J,358.3,19336,2)
;;=^5036707
;;^UTILITY(U,$J,358.3,19337,0)
;;=S88.919S^^65^791^2
;;^UTILITY(U,$J,358.3,19337,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19337,1,3,0)
;;=3^Complete traumatic amp of unsp low leg, level unsp, sequela
;;^UTILITY(U,$J,358.3,19337,1,4,0)
;;=4^S88.919S
;;^UTILITY(U,$J,358.3,19337,2)
;;=^5137219
;;^UTILITY(U,$J,358.3,19338,0)
;;=S48.919S^^65^791^3
;;^UTILITY(U,$J,358.3,19338,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19338,1,3,0)
;;=3^Complete traumatic amp of unsp shldr/up arm, level unsp, sequela
;;^UTILITY(U,$J,358.3,19338,1,4,0)
;;=4^S48.919S
;;^UTILITY(U,$J,358.3,19338,2)
;;=^5028331
;;^UTILITY(U,$J,358.3,19339,0)
;;=S14.2XXS^^65^791^6
;;^UTILITY(U,$J,358.3,19339,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19339,1,3,0)
;;=3^Injury of nerve root of cervical spine, sequela
;;^UTILITY(U,$J,358.3,19339,1,4,0)
;;=4^S14.2XXS
;;^UTILITY(U,$J,358.3,19339,2)
;;=^5022204
;;^UTILITY(U,$J,358.3,19340,0)
;;=S34.21XS^^65^791^7
;;^UTILITY(U,$J,358.3,19340,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19340,1,3,0)
;;=3^Injury of nerve root of lumbar spine, sequela
;;^UTILITY(U,$J,358.3,19340,1,4,0)
;;=4^S34.21XS
;;^UTILITY(U,$J,358.3,19340,2)
;;=^5025252
;;^UTILITY(U,$J,358.3,19341,0)
;;=S34.22XS^^65^791^8
;;^UTILITY(U,$J,358.3,19341,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19341,1,3,0)
;;=3^Injury of nerve root of sacral spine, sequela
;;^UTILITY(U,$J,358.3,19341,1,4,0)
;;=4^S34.22XS
;;^UTILITY(U,$J,358.3,19341,2)
;;=^5025255
;;^UTILITY(U,$J,358.3,19342,0)
;;=S24.2XXS^^65^791^9
;;^UTILITY(U,$J,358.3,19342,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19342,1,3,0)
;;=3^Injury of nerve root of thoracic spine, sequela
;;^UTILITY(U,$J,358.3,19342,1,4,0)
;;=4^S24.2XXS
;;^UTILITY(U,$J,358.3,19342,2)
;;=^5023347
;;^UTILITY(U,$J,358.3,19343,0)
;;=S04.9XXS^^65^791^11
;;^UTILITY(U,$J,358.3,19343,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19343,1,3,0)
;;=3^Injury of unspec cranial nerve, sequela
;;^UTILITY(U,$J,358.3,19343,1,4,0)
;;=4^S04.9XXS
;;^UTILITY(U,$J,358.3,19343,2)
;;=^5020575
;;^UTILITY(U,$J,358.3,19344,0)
;;=S24.9XXS^^65^791^12
;;^UTILITY(U,$J,358.3,19344,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19344,1,3,0)
;;=3^Injury of unspec nerve of thorax, sequela
;;^UTILITY(U,$J,358.3,19344,1,4,0)
;;=4^S24.9XXS
;;^UTILITY(U,$J,358.3,19344,2)
;;=^5023359
;;^UTILITY(U,$J,358.3,19345,0)
;;=S34.9XXS^^65^791^18
;;^UTILITY(U,$J,358.3,19345,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19345,1,3,0)
;;=3^Injury to unspec nerves at abd/low back/pelvis level, sequela
;;^UTILITY(U,$J,358.3,19345,1,4,0)
;;=4^S34.9XXS
;;^UTILITY(U,$J,358.3,19345,2)
;;=^5025273
;;^UTILITY(U,$J,358.3,19346,0)
;;=S14.9XXS^^65^791^13
;;^UTILITY(U,$J,358.3,19346,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19346,1,3,0)
;;=3^Injury of unspec nerves of neck, sequela
;;^UTILITY(U,$J,358.3,19346,1,4,0)
;;=4^S14.9XXS
;;^UTILITY(U,$J,358.3,19346,2)
;;=^5022219
;;^UTILITY(U,$J,358.3,19347,0)
;;=S58.922S^^65^791^20
;;^UTILITY(U,$J,358.3,19347,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19347,1,3,0)
;;=3^Partial traumatic amp of l forearm, level unsp, sequela
;;^UTILITY(U,$J,358.3,19347,1,4,0)
;;=4^S58.922S
;;^UTILITY(U,$J,358.3,19347,2)
;;=^5031957
;;^UTILITY(U,$J,358.3,19348,0)
;;=S14.109S^^65^791^15
;;^UTILITY(U,$J,358.3,19348,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19348,1,3,0)
;;=3^Injury to unsp level of cervical spinal cord unspec, sequela
;;^UTILITY(U,$J,358.3,19348,1,4,0)
;;=4^S14.109S
;;^UTILITY(U,$J,358.3,19348,2)
;;=^5134243
;;^UTILITY(U,$J,358.3,19349,0)
;;=S24.109S^^65^791^17
;;^UTILITY(U,$J,358.3,19349,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19349,1,3,0)
;;=3^Injury to unsp level of thoracic spinal cord, sequela
;;^UTILITY(U,$J,358.3,19349,1,4,0)
;;=4^S24.109S
;;^UTILITY(U,$J,358.3,19349,2)
;;=^5134384
;;^UTILITY(U,$J,358.3,19350,0)
;;=S34.139S^^65^791^14
;;^UTILITY(U,$J,358.3,19350,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19350,1,3,0)
;;=3^Injury to sacral spinal cord, sequela
;;^UTILITY(U,$J,358.3,19350,1,4,0)
;;=4^S34.139S
;;^UTILITY(U,$J,358.3,19350,2)
;;=^5025249
;;^UTILITY(U,$J,358.3,19351,0)
;;=S34.109S^^65^791^16
;;^UTILITY(U,$J,358.3,19351,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19351,1,3,0)
;;=3^Injury to unsp level of lumbar spinal cord, sequela
;;^UTILITY(U,$J,358.3,19351,1,4,0)
;;=4^S34.109S
;;^UTILITY(U,$J,358.3,19351,2)
;;=^5134570
;;^UTILITY(U,$J,358.3,19352,0)
;;=S06.9X9S^^65^791^19
;;^UTILITY(U,$J,358.3,19352,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19352,1,3,0)
;;=3^Intracranial injury w LOC of unsp duration, sequela
;;^UTILITY(U,$J,358.3,19352,1,4,0)
;;=4^S06.9X9S
;;^UTILITY(U,$J,358.3,19352,2)
;;=^5021235
;;^UTILITY(U,$J,358.3,19353,0)
;;=S15.002A^^65^791^5
;;^UTILITY(U,$J,358.3,19353,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19353,1,3,0)
;;=3^Injury of left carotid artery, init encntr
;;^UTILITY(U,$J,358.3,19353,1,4,0)
;;=4^S15.002A
;;^UTILITY(U,$J,358.3,19353,2)
;;=^5022223
;;^UTILITY(U,$J,358.3,19354,0)
;;=S15.001A^^65^791^10
;;^UTILITY(U,$J,358.3,19354,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19354,1,3,0)
;;=3^Injury of right carotid artery, init encntr
;;^UTILITY(U,$J,358.3,19354,1,4,0)
;;=4^S15.001A
;;^UTILITY(U,$J,358.3,19354,2)
;;=^5022220
;;^UTILITY(U,$J,358.3,19355,0)
;;=I69.952^^65^792^12
;;^UTILITY(U,$J,358.3,19355,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19355,1,3,0)
;;=3^Hemiplagia,Left Dominant Side
;;^UTILITY(U,$J,358.3,19355,1,4,0)
;;=4^I69.952
;;^UTILITY(U,$J,358.3,19355,2)
;;=^5133586
;;^UTILITY(U,$J,358.3,19356,0)
;;=I69.954^^65^792^13
;;^UTILITY(U,$J,358.3,19356,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19356,1,3,0)
;;=3^Hemiplegia,Left Non-Dominant Side
;;^UTILITY(U,$J,358.3,19356,1,4,0)
;;=4^I69.954
;;^UTILITY(U,$J,358.3,19356,2)
;;=^5133587
;;^UTILITY(U,$J,358.3,19357,0)
;;=I69.951^^65^792^14
;;^UTILITY(U,$J,358.3,19357,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19357,1,3,0)
;;=3^Hemiplegia,Right Dominant Side
;;^UTILITY(U,$J,358.3,19357,1,4,0)
;;=4^I69.951
;;^UTILITY(U,$J,358.3,19357,2)
;;=^5007561
;;^UTILITY(U,$J,358.3,19358,0)
;;=I69.953^^65^792^15
;;^UTILITY(U,$J,358.3,19358,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19358,1,3,0)
;;=3^Hemiplegia,Right Non-Dominant Side
;;^UTILITY(U,$J,358.3,19358,1,4,0)
;;=4^I69.953
;;^UTILITY(U,$J,358.3,19358,2)
;;=^5007562
;;^UTILITY(U,$J,358.3,19359,0)
;;=I69.920^^65^792^1
;;^UTILITY(U,$J,358.3,19359,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19359,1,3,0)
;;=3^Aphasia
;;^UTILITY(U,$J,358.3,19359,1,4,0)
;;=4^I69.920
;;^UTILITY(U,$J,358.3,19359,2)
;;=^5007553
;;^UTILITY(U,$J,358.3,19360,0)
;;=I69.90^^65^792^30
;;^UTILITY(U,$J,358.3,19360,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19360,1,3,0)
;;=3^Unspec Sequela of Unspec CVA
;;^UTILITY(U,$J,358.3,19360,1,4,0)
;;=4^I69.90
;;^UTILITY(U,$J,358.3,19360,2)
;;=^5007551
;;^UTILITY(U,$J,358.3,19361,0)
;;=I69.910^^65^792^4
;;^UTILITY(U,$J,358.3,19361,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19361,1,3,0)
;;=3^Attention & Concentration Deficit
;;^UTILITY(U,$J,358.3,19361,1,4,0)
;;=4^I69.910
;;^UTILITY(U,$J,358.3,19361,2)
;;=^5138660
;;^UTILITY(U,$J,358.3,19362,0)
;;=I69.911^^65^792^16
;;^UTILITY(U,$J,358.3,19362,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19362,1,3,0)
;;=3^Memory Deficit
;;^UTILITY(U,$J,358.3,19362,1,4,0)
;;=4^I69.911
;;^UTILITY(U,$J,358.3,19362,2)
;;=^5138661
;;^UTILITY(U,$J,358.3,19363,0)
;;=I69.912^^65^792^31
;;^UTILITY(U,$J,358.3,19363,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19363,1,3,0)
;;=3^Visuspatial Deficit & Spatial Neglect
;;^UTILITY(U,$J,358.3,19363,1,4,0)
;;=4^I69.912
;;^UTILITY(U,$J,358.3,19363,2)
;;=^5138662
;;^UTILITY(U,$J,358.3,19364,0)
;;=I69.913^^65^792^27
;;^UTILITY(U,$J,358.3,19364,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19364,1,3,0)
;;=3^Psychomotor Deficit
;;^UTILITY(U,$J,358.3,19364,1,4,0)
;;=4^I69.913
;;^UTILITY(U,$J,358.3,19364,2)
;;=^5138663
;;^UTILITY(U,$J,358.3,19365,0)
;;=I69.914^^65^792^11
;;^UTILITY(U,$J,358.3,19365,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19365,1,3,0)
;;=3^Frontal Lobe & Executive Function Deficit
;;^UTILITY(U,$J,358.3,19365,1,4,0)
;;=4^I69.914
;;^UTILITY(U,$J,358.3,19365,2)
;;=^5138664
;;^UTILITY(U,$J,358.3,19366,0)
;;=I69.915^^65^792^5
;;^UTILITY(U,$J,358.3,19366,1,0)
;;=^358.31IA^4^2
;;^UTILITY(U,$J,358.3,19366,1,3,0)
;;=3^Cognitive Social/Emotional Deficit
;;^UTILITY(U,$J,358.3,19366,1,4,0)
;;=4^I69.915
;;^UTILITY(U,$J,358.3,19366,2)
;;=^5138665
--- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HIBDEI07X 19788 printed Sep 23, 2025@19:19:23 Page 2
IBDEI07X ; ; 01-AUG-2022
+1 ;;3.0;IB ENCOUNTER FORM IMP/EXP;;AUG 01, 2022
+2 if 'DIFQR(358.3)
QUIT
FOR I=1:2
SET X=$TEXT(Q+I)
if X=""
QUIT
SET Y=$EXTRACT($TEXT(Q+I+1),4,999)
SET X=$EXTRACT(X,4,999)
if $ASCII(Y)=126
SET I=I+1
SET Y=$EXTRACT(Y,2,999)_$EXTRACT($TEXT(Q+I+1),5,999)
if $ASCII(Y)=61
SET Y=$EXTRACT(Y,2,999)
XECUTE NO
IF '$TEST
SET @X=Y
Q QUIT
+1 ;;^UTILITY(U,$J,358.3,19300,0)
+2 ;;=99080^^64^789^38^^^^1
+3 ;;^UTILITY(U,$J,358.3,19300,1,0)
+4 ;;=^358.31IA^3^2
+5 ;;^UTILITY(U,$J,358.3,19300,1,2,0)
+6 ;;=2^Special Reports or Forms
+7 ;;^UTILITY(U,$J,358.3,19300,1,3,0)
+8 ;;=3^99080
+9 ;;^UTILITY(U,$J,358.3,19301,0)
+10 ;;=29105^^64^789^3^^^^1
+11 ;;^UTILITY(U,$J,358.3,19301,1,0)
+12 ;;=^358.31IA^3^2
+13 ;;^UTILITY(U,$J,358.3,19301,1,2,0)
+14 ;;=2^Apply Long Arm Splint,Static
+15 ;;^UTILITY(U,$J,358.3,19301,1,3,0)
+16 ;;=3^29105
+17 ;;^UTILITY(U,$J,358.3,19302,0)
+18 ;;=29125^^64^789^6^^^^1
+19 ;;^UTILITY(U,$J,358.3,19302,1,0)
+20 ;;=^358.31IA^3^2
+21 ;;^UTILITY(U,$J,358.3,19302,1,2,0)
+22 ;;=2^Apply Short Arm Splint,Static
+23 ;;^UTILITY(U,$J,358.3,19302,1,3,0)
+24 ;;=3^29125
+25 ;;^UTILITY(U,$J,358.3,19303,0)
+26 ;;=29126^^64^789^5^^^^1
+27 ;;^UTILITY(U,$J,358.3,19303,1,0)
+28 ;;=^358.31IA^3^2
+29 ;;^UTILITY(U,$J,358.3,19303,1,2,0)
+30 ;;=2^Apply Short Arm Splint,Dynamic
+31 ;;^UTILITY(U,$J,358.3,19303,1,3,0)
+32 ;;=3^29126
+33 ;;^UTILITY(U,$J,358.3,19304,0)
+34 ;;=29130^^64^789^2^^^^1
+35 ;;^UTILITY(U,$J,358.3,19304,1,0)
+36 ;;=^358.31IA^3^2
+37 ;;^UTILITY(U,$J,358.3,19304,1,2,0)
+38 ;;=2^Apply Finger Splint,Static
+39 ;;^UTILITY(U,$J,358.3,19304,1,3,0)
+40 ;;=3^29130
+41 ;;^UTILITY(U,$J,358.3,19305,0)
+42 ;;=29131^^64^789^1^^^^1
+43 ;;^UTILITY(U,$J,358.3,19305,1,0)
+44 ;;=^358.31IA^3^2
+45 ;;^UTILITY(U,$J,358.3,19305,1,2,0)
+46 ;;=2^Apply Finger Splint,Dynamic
+47 ;;^UTILITY(U,$J,358.3,19305,1,3,0)
+48 ;;=3^29131
+49 ;;^UTILITY(U,$J,358.3,19306,0)
+50 ;;=S9451^^64^789^19^^^^1
+51 ;;^UTILITY(U,$J,358.3,19306,1,0)
+52 ;;=^358.31IA^3^2
+53 ;;^UTILITY(U,$J,358.3,19306,1,2,0)
+54 ;;=2^Exercise Class per Session
+55 ;;^UTILITY(U,$J,358.3,19306,1,3,0)
+56 ;;=3^S9451
+57 ;;^UTILITY(U,$J,358.3,19307,0)
+58 ;;=97129^^64^789^45^^^^1
+59 ;;^UTILITY(U,$J,358.3,19307,1,0)
+60 ;;=^358.31IA^3^2
+61 ;;^UTILITY(U,$J,358.3,19307,1,2,0)
+62 ;;=2^Therapy Intrvn Cognitive Func,1st 15 min
+63 ;;^UTILITY(U,$J,358.3,19307,1,3,0)
+64 ;;=3^97129
+65 ;;^UTILITY(U,$J,358.3,19308,0)
+66 ;;=97130^^64^789^46^^^^1
+67 ;;^UTILITY(U,$J,358.3,19308,1,0)
+68 ;;=^358.31IA^3^2
+69 ;;^UTILITY(U,$J,358.3,19308,1,2,0)
+70 ;;=2^Therapy Intrvn Cognitive Func,Ea Addl 15 min
+71 ;;^UTILITY(U,$J,358.3,19308,1,3,0)
+72 ;;=3^97130
+73 ;;^UTILITY(U,$J,358.3,19309,0)
+74 ;;=90912^^64^789^9^^^^1
+75 ;;^UTILITY(U,$J,358.3,19309,1,0)
+76 ;;=^358.31IA^3^2
+77 ;;^UTILITY(U,$J,358.3,19309,1,2,0)
+78 ;;=2^Biofdbk Trng Peri/Uro/Rectal,1st 15 min
+79 ;;^UTILITY(U,$J,358.3,19309,1,3,0)
+80 ;;=3^90912
+81 ;;^UTILITY(U,$J,358.3,19310,0)
+82 ;;=90913^^64^789^10^^^^1
+83 ;;^UTILITY(U,$J,358.3,19310,1,0)
+84 ;;=^358.31IA^3^2
+85 ;;^UTILITY(U,$J,358.3,19310,1,2,0)
+86 ;;=2^Biofdbk Trng Peri/Uro/Rectal,Ea Addl 15 min
+87 ;;^UTILITY(U,$J,358.3,19310,1,3,0)
+88 ;;=3^90913
+89 ;;^UTILITY(U,$J,358.3,19311,0)
+90 ;;=S06.0X1A^^65^790^1
+91 ;;^UTILITY(U,$J,358.3,19311,1,0)
+92 ;;=^358.31IA^4^2
+93 ;;^UTILITY(U,$J,358.3,19311,1,3,0)
+94 ;;=3^Concussion w LOC of 30 minutes or less, init
+95 ;;^UTILITY(U,$J,358.3,19311,1,4,0)
+96 ;;=4^S06.0X1A
+97 ;;^UTILITY(U,$J,358.3,19311,2)
+98 ;;=^5020669
+99 ;;^UTILITY(U,$J,358.3,19312,0)
+100 ;;=S06.0X9A^^65^790^2
+101 ;;^UTILITY(U,$J,358.3,19312,1,0)
+102 ;;=^358.31IA^4^2
+103 ;;^UTILITY(U,$J,358.3,19312,1,3,0)
+104 ;;=3^Concussion w LOC of unsp duration, init
+105 ;;^UTILITY(U,$J,358.3,19312,1,4,0)
+106 ;;=4^S06.0X9A
+107 ;;^UTILITY(U,$J,358.3,19312,2)
+108 ;;=^5020693
+109 ;;^UTILITY(U,$J,358.3,19313,0)
+110 ;;=S06.0X0A^^65^790^3
+111 ;;^UTILITY(U,$J,358.3,19313,1,0)
+112 ;;=^358.31IA^4^2
+113 ;;^UTILITY(U,$J,358.3,19313,1,3,0)
+114 ;;=3^Concussion w/o LOC, initial encounter
+115 ;;^UTILITY(U,$J,358.3,19313,1,4,0)
+116 ;;=4^S06.0X0A
+117 ;;^UTILITY(U,$J,358.3,19313,2)
+118 ;;=^5020666
+119 ;;^UTILITY(U,$J,358.3,19314,0)
+120 ;;=Z13.850^^65^790^14
+121 ;;^UTILITY(U,$J,358.3,19314,1,0)
+122 ;;=^358.31IA^4^2
+123 ;;^UTILITY(U,$J,358.3,19314,1,3,0)
+124 ;;=3^TBI Screening
+125 ;;^UTILITY(U,$J,358.3,19314,1,4,0)
+126 ;;=4^Z13.850
+127 ;;^UTILITY(U,$J,358.3,19314,2)
+128 ;;=^5062717
+129 ;;^UTILITY(U,$J,358.3,19315,0)
+130 ;;=Z87.820^^65^790^13
+131 ;;^UTILITY(U,$J,358.3,19315,1,0)
+132 ;;=^358.31IA^4^2
+133 ;;^UTILITY(U,$J,358.3,19315,1,3,0)
+134 ;;=3^Personal history of traumatic brain injury
+135 ;;^UTILITY(U,$J,358.3,19315,1,4,0)
+136 ;;=4^Z87.820
+137 ;;^UTILITY(U,$J,358.3,19315,2)
+138 ;;=^5063514
+139 ;;^UTILITY(U,$J,358.3,19316,0)
+140 ;;=S06.890A^^65^790^11
+141 ;;^UTILITY(U,$J,358.3,19316,1,0)
+142 ;;=^358.31IA^4^2
+143 ;;^UTILITY(U,$J,358.3,19316,1,3,0)
+144 ;;=3^Intcrn inj w/o LOC, init encntr
+145 ;;^UTILITY(U,$J,358.3,19316,1,4,0)
+146 ;;=4^S06.890A
+147 ;;^UTILITY(U,$J,358.3,19316,2)
+148 ;;=^5021176
+149 ;;^UTILITY(U,$J,358.3,19317,0)
+150 ;;=S06.1X5A^^65^790^15
+151 ;;^UTILITY(U,$J,358.3,19317,1,0)
+152 ;;=^358.31IA^4^2
+153 ;;^UTILITY(U,$J,358.3,19317,1,3,0)
+154 ;;=3^Traumatic cerebral edema w LOC >24 hr w ret consc lev, init
+155 ;;^UTILITY(U,$J,358.3,19317,1,4,0)
+156 ;;=4^S06.1X5A
+157 ;;^UTILITY(U,$J,358.3,19317,2)
+158 ;;=^5020711
+159 ;;^UTILITY(U,$J,358.3,19318,0)
+160 ;;=S06.1X6A^^65^790^16
+161 ;;^UTILITY(U,$J,358.3,19318,1,0)
+162 ;;=^358.31IA^4^2
+163 ;;^UTILITY(U,$J,358.3,19318,1,3,0)
+164 ;;=3^Traumatic cerebral edema w LOC >24 hr w/o ret consc w surv, init
+165 ;;^UTILITY(U,$J,358.3,19318,1,4,0)
+166 ;;=4^S06.1X6A
+167 ;;^UTILITY(U,$J,358.3,19318,2)
+168 ;;=^5020714
+169 ;;^UTILITY(U,$J,358.3,19319,0)
+170 ;;=S06.1X3A^^65^790^17
+171 ;;^UTILITY(U,$J,358.3,19319,1,0)
+172 ;;=^358.31IA^4^2
+173 ;;^UTILITY(U,$J,358.3,19319,1,3,0)
+174 ;;=3^Traumatic cerebral edema w LOC of 1-5 hrs 59 min, init
+175 ;;^UTILITY(U,$J,358.3,19319,1,4,0)
+176 ;;=4^S06.1X3A
+177 ;;^UTILITY(U,$J,358.3,19319,2)
+178 ;;=^5020705
+179 ;;^UTILITY(U,$J,358.3,19320,0)
+180 ;;=S06.1X1A^^65^790^18
+181 ;;^UTILITY(U,$J,358.3,19320,1,0)
+182 ;;=^358.31IA^4^2
+183 ;;^UTILITY(U,$J,358.3,19320,1,3,0)
+184 ;;=3^Traumatic cerebral edema w LOC of 30 minutes or less, init
+185 ;;^UTILITY(U,$J,358.3,19320,1,4,0)
+186 ;;=4^S06.1X1A
+187 ;;^UTILITY(U,$J,358.3,19320,2)
+188 ;;=^5020699
+189 ;;^UTILITY(U,$J,358.3,19321,0)
+190 ;;=S06.1X2A^^65^790^19
+191 ;;^UTILITY(U,$J,358.3,19321,1,0)
+192 ;;=^358.31IA^4^2
+193 ;;^UTILITY(U,$J,358.3,19321,1,3,0)
+194 ;;=3^Traumatic cerebral edema w LOC of 31-59 min, init
+195 ;;^UTILITY(U,$J,358.3,19321,1,4,0)
+196 ;;=4^S06.1X2A
+197 ;;^UTILITY(U,$J,358.3,19321,2)
+198 ;;=^5020702
+199 ;;^UTILITY(U,$J,358.3,19322,0)
+200 ;;=S06.1X4A^^65^790^20
+201 ;;^UTILITY(U,$J,358.3,19322,1,0)
+202 ;;=^358.31IA^4^2
+203 ;;^UTILITY(U,$J,358.3,19322,1,3,0)
+204 ;;=3^Traumatic cerebral edema w LOC of 6 hours to 24 hours, init
+205 ;;^UTILITY(U,$J,358.3,19322,1,4,0)
+206 ;;=4^S06.1X4A
+207 ;;^UTILITY(U,$J,358.3,19322,2)
+208 ;;=^5020708
+209 ;;^UTILITY(U,$J,358.3,19323,0)
+210 ;;=S06.1X7A^^65^790^22
+211 ;;^UTILITY(U,$J,358.3,19323,1,0)
+212 ;;=^358.31IA^4^2
+213 ;;^UTILITY(U,$J,358.3,19323,1,3,0)
+214 ;;=3^Traumatic cerebral edema w LOC w death d/t brain inj bf consc, init
+215 ;;^UTILITY(U,$J,358.3,19323,1,4,0)
+216 ;;=4^S06.1X7A
+217 ;;^UTILITY(U,$J,358.3,19323,2)
+218 ;;=^5020717
+219 ;;^UTILITY(U,$J,358.3,19324,0)
+220 ;;=S06.1X8A^^65^790^23
+221 ;;^UTILITY(U,$J,358.3,19324,1,0)
+222 ;;=^358.31IA^4^2
+223 ;;^UTILITY(U,$J,358.3,19324,1,3,0)
+224 ;;=3^Traumatic cerebral edema w LOC w death d/t oth cause bf consc, init
+225 ;;^UTILITY(U,$J,358.3,19324,1,4,0)
+226 ;;=4^S06.1X8A
+227 ;;^UTILITY(U,$J,358.3,19324,2)
+228 ;;=^5020720
+229 ;;^UTILITY(U,$J,358.3,19325,0)
+230 ;;=S06.1X9A^^65^790^21
+231 ;;^UTILITY(U,$J,358.3,19325,1,0)
+232 ;;=^358.31IA^4^2
+233 ;;^UTILITY(U,$J,358.3,19325,1,3,0)
+234 ;;=3^Traumatic cerebral edema w LOC of unsp duration, init
+235 ;;^UTILITY(U,$J,358.3,19325,1,4,0)
+236 ;;=4^S06.1X9A
+237 ;;^UTILITY(U,$J,358.3,19325,2)
+238 ;;=^5020723
+239 ;;^UTILITY(U,$J,358.3,19326,0)
+240 ;;=S06.1X0A^^65^790^24
+241 ;;^UTILITY(U,$J,358.3,19326,1,0)
+242 ;;=^358.31IA^4^2
+243 ;;^UTILITY(U,$J,358.3,19326,1,3,0)
+244 ;;=3^Traumatic cerebral edema w/o LOC, init
+245 ;;^UTILITY(U,$J,358.3,19326,1,4,0)
+246 ;;=4^S06.1X0A
+247 ;;^UTILITY(U,$J,358.3,19326,2)
+248 ;;=^5020696
+249 ;;^UTILITY(U,$J,358.3,19327,0)
+250 ;;=S06.9X5A^^65^790^4
+251 ;;^UTILITY(U,$J,358.3,19327,1,0)
+252 ;;=^358.31IA^4^2
+253 ;;^UTILITY(U,$J,358.3,19327,1,3,0)
+254 ;;=3^Intcrn inj w LOC >24 hr w ret consc lev, init encntr,Unspec
+255 ;;^UTILITY(U,$J,358.3,19327,1,4,0)
+256 ;;=4^S06.9X5A
+257 ;;^UTILITY(U,$J,358.3,19327,2)
+258 ;;=^5021221
+259 ;;^UTILITY(U,$J,358.3,19328,0)
+260 ;;=S06.9X6A^^65^790^5
+261 ;;^UTILITY(U,$J,358.3,19328,1,0)
+262 ;;=^358.31IA^4^2
+263 ;;^UTILITY(U,$J,358.3,19328,1,3,0)
+264 ;;=3^Intcrn inj w LOC >24 hr w/o ret consc w surv, init encntr,Unspec
+265 ;;^UTILITY(U,$J,358.3,19328,1,4,0)
+266 ;;=4^S06.9X6A
+267 ;;^UTILITY(U,$J,358.3,19328,2)
+268 ;;=^5021224
+269 ;;^UTILITY(U,$J,358.3,19329,0)
+270 ;;=S06.9X3A^^65^790^6
+271 ;;^UTILITY(U,$J,358.3,19329,1,0)
+272 ;;=^358.31IA^4^2
+273 ;;^UTILITY(U,$J,358.3,19329,1,3,0)
+274 ;;=3^Intcrn inj w LOC of 1-5 hrs 59 min, init encntr,Unspec
+275 ;;^UTILITY(U,$J,358.3,19329,1,4,0)
+276 ;;=4^S06.9X3A
+277 ;;^UTILITY(U,$J,358.3,19329,2)
+278 ;;=^5021215
+279 ;;^UTILITY(U,$J,358.3,19330,0)
+280 ;;=S06.9X1A^^65^790^7
+281 ;;^UTILITY(U,$J,358.3,19330,1,0)
+282 ;;=^358.31IA^4^2
+283 ;;^UTILITY(U,$J,358.3,19330,1,3,0)
+284 ;;=3^Intcrn inj w LOC of 30 minutes or less, init encntr,Unspec
+285 ;;^UTILITY(U,$J,358.3,19330,1,4,0)
+286 ;;=4^S06.9X1A
+287 ;;^UTILITY(U,$J,358.3,19330,2)
+288 ;;=^5021209
+289 ;;^UTILITY(U,$J,358.3,19331,0)
+290 ;;=S06.9X2A^^65^790^8
+291 ;;^UTILITY(U,$J,358.3,19331,1,0)
+292 ;;=^358.31IA^4^2
+293 ;;^UTILITY(U,$J,358.3,19331,1,3,0)
+294 ;;=3^Intcrn inj w LOC of 31-59 min, init encntr,Unspec
+295 ;;^UTILITY(U,$J,358.3,19331,1,4,0)
+296 ;;=4^S06.9X2A
+297 ;;^UTILITY(U,$J,358.3,19331,2)
+298 ;;=^5021212
+299 ;;^UTILITY(U,$J,358.3,19332,0)
+300 ;;=S06.9X4A^^65^790^9
+301 ;;^UTILITY(U,$J,358.3,19332,1,0)
+302 ;;=^358.31IA^4^2
+303 ;;^UTILITY(U,$J,358.3,19332,1,3,0)
+304 ;;=3^Intcrn inj w LOC of 6 hours to 24 hours, init encntr,Unspec
+305 ;;^UTILITY(U,$J,358.3,19332,1,4,0)
+306 ;;=4^S06.9X4A
+307 ;;^UTILITY(U,$J,358.3,19332,2)
+308 ;;=^5021218
+309 ;;^UTILITY(U,$J,358.3,19333,0)
+310 ;;=S06.9X9A^^65^790^10
+311 ;;^UTILITY(U,$J,358.3,19333,1,0)
+312 ;;=^358.31IA^4^2
+313 ;;^UTILITY(U,$J,358.3,19333,1,3,0)
+314 ;;=3^Intcrn inj w LOC of unsp duration, init encntr,Unspec
+315 ;;^UTILITY(U,$J,358.3,19333,1,4,0)
+316 ;;=4^S06.9X9A
+317 ;;^UTILITY(U,$J,358.3,19333,2)
+318 ;;=^5021233
+319 ;;^UTILITY(U,$J,358.3,19334,0)
+320 ;;=S06.9X0A^^65^790^12
+321 ;;^UTILITY(U,$J,358.3,19334,1,0)
+322 ;;=^358.31IA^4^2
+323 ;;^UTILITY(U,$J,358.3,19334,1,3,0)
+324 ;;=3^Intcrn inj w/o LOC, init encntr,Unspec
+325 ;;^UTILITY(U,$J,358.3,19334,1,4,0)
+326 ;;=4^S06.9X0A
+327 ;;^UTILITY(U,$J,358.3,19334,2)
+328 ;;=^5021206
+329 ;;^UTILITY(U,$J,358.3,19335,0)
+330 ;;=S78.019S^^65^791^4
+331 ;;^UTILITY(U,$J,358.3,19335,1,0)
+332 ;;=^358.31IA^4^2
+333 ;;^UTILITY(U,$J,358.3,19335,1,3,0)
+334 ;;=3^Complete traumatic amputation at unsp hip joint, sequela
+335 ;;^UTILITY(U,$J,358.3,19335,1,4,0)
+336 ;;=4^S78.019S
+337 ;;^UTILITY(U,$J,358.3,19335,2)
+338 ;;=^5039710
+339 ;;^UTILITY(U,$J,358.3,19336,0)
+340 ;;=S68.419S^^65^791^1
+341 ;;^UTILITY(U,$J,358.3,19336,1,0)
+342 ;;=^358.31IA^4^2
+343 ;;^UTILITY(U,$J,358.3,19336,1,3,0)
+344 ;;=3^Complete traumatic amp of unsp hand at wrist level, sequela
+345 ;;^UTILITY(U,$J,358.3,19336,1,4,0)
+346 ;;=4^S68.419S
+347 ;;^UTILITY(U,$J,358.3,19336,2)
+348 ;;=^5036707
+349 ;;^UTILITY(U,$J,358.3,19337,0)
+350 ;;=S88.919S^^65^791^2
+351 ;;^UTILITY(U,$J,358.3,19337,1,0)
+352 ;;=^358.31IA^4^2
+353 ;;^UTILITY(U,$J,358.3,19337,1,3,0)
+354 ;;=3^Complete traumatic amp of unsp low leg, level unsp, sequela
+355 ;;^UTILITY(U,$J,358.3,19337,1,4,0)
+356 ;;=4^S88.919S
+357 ;;^UTILITY(U,$J,358.3,19337,2)
+358 ;;=^5137219
+359 ;;^UTILITY(U,$J,358.3,19338,0)
+360 ;;=S48.919S^^65^791^3
+361 ;;^UTILITY(U,$J,358.3,19338,1,0)
+362 ;;=^358.31IA^4^2
+363 ;;^UTILITY(U,$J,358.3,19338,1,3,0)
+364 ;;=3^Complete traumatic amp of unsp shldr/up arm, level unsp, sequela
+365 ;;^UTILITY(U,$J,358.3,19338,1,4,0)
+366 ;;=4^S48.919S
+367 ;;^UTILITY(U,$J,358.3,19338,2)
+368 ;;=^5028331
+369 ;;^UTILITY(U,$J,358.3,19339,0)
+370 ;;=S14.2XXS^^65^791^6
+371 ;;^UTILITY(U,$J,358.3,19339,1,0)
+372 ;;=^358.31IA^4^2
+373 ;;^UTILITY(U,$J,358.3,19339,1,3,0)
+374 ;;=3^Injury of nerve root of cervical spine, sequela
+375 ;;^UTILITY(U,$J,358.3,19339,1,4,0)
+376 ;;=4^S14.2XXS
+377 ;;^UTILITY(U,$J,358.3,19339,2)
+378 ;;=^5022204
+379 ;;^UTILITY(U,$J,358.3,19340,0)
+380 ;;=S34.21XS^^65^791^7
+381 ;;^UTILITY(U,$J,358.3,19340,1,0)
+382 ;;=^358.31IA^4^2
+383 ;;^UTILITY(U,$J,358.3,19340,1,3,0)
+384 ;;=3^Injury of nerve root of lumbar spine, sequela
+385 ;;^UTILITY(U,$J,358.3,19340,1,4,0)
+386 ;;=4^S34.21XS
+387 ;;^UTILITY(U,$J,358.3,19340,2)
+388 ;;=^5025252
+389 ;;^UTILITY(U,$J,358.3,19341,0)
+390 ;;=S34.22XS^^65^791^8
+391 ;;^UTILITY(U,$J,358.3,19341,1,0)
+392 ;;=^358.31IA^4^2
+393 ;;^UTILITY(U,$J,358.3,19341,1,3,0)
+394 ;;=3^Injury of nerve root of sacral spine, sequela
+395 ;;^UTILITY(U,$J,358.3,19341,1,4,0)
+396 ;;=4^S34.22XS
+397 ;;^UTILITY(U,$J,358.3,19341,2)
+398 ;;=^5025255
+399 ;;^UTILITY(U,$J,358.3,19342,0)
+400 ;;=S24.2XXS^^65^791^9
+401 ;;^UTILITY(U,$J,358.3,19342,1,0)
+402 ;;=^358.31IA^4^2
+403 ;;^UTILITY(U,$J,358.3,19342,1,3,0)
+404 ;;=3^Injury of nerve root of thoracic spine, sequela
+405 ;;^UTILITY(U,$J,358.3,19342,1,4,0)
+406 ;;=4^S24.2XXS
+407 ;;^UTILITY(U,$J,358.3,19342,2)
+408 ;;=^5023347
+409 ;;^UTILITY(U,$J,358.3,19343,0)
+410 ;;=S04.9XXS^^65^791^11
+411 ;;^UTILITY(U,$J,358.3,19343,1,0)
+412 ;;=^358.31IA^4^2
+413 ;;^UTILITY(U,$J,358.3,19343,1,3,0)
+414 ;;=3^Injury of unspec cranial nerve, sequela
+415 ;;^UTILITY(U,$J,358.3,19343,1,4,0)
+416 ;;=4^S04.9XXS
+417 ;;^UTILITY(U,$J,358.3,19343,2)
+418 ;;=^5020575
+419 ;;^UTILITY(U,$J,358.3,19344,0)
+420 ;;=S24.9XXS^^65^791^12
+421 ;;^UTILITY(U,$J,358.3,19344,1,0)
+422 ;;=^358.31IA^4^2
+423 ;;^UTILITY(U,$J,358.3,19344,1,3,0)
+424 ;;=3^Injury of unspec nerve of thorax, sequela
+425 ;;^UTILITY(U,$J,358.3,19344,1,4,0)
+426 ;;=4^S24.9XXS
+427 ;;^UTILITY(U,$J,358.3,19344,2)
+428 ;;=^5023359
+429 ;;^UTILITY(U,$J,358.3,19345,0)
+430 ;;=S34.9XXS^^65^791^18
+431 ;;^UTILITY(U,$J,358.3,19345,1,0)
+432 ;;=^358.31IA^4^2
+433 ;;^UTILITY(U,$J,358.3,19345,1,3,0)
+434 ;;=3^Injury to unspec nerves at abd/low back/pelvis level, sequela
+435 ;;^UTILITY(U,$J,358.3,19345,1,4,0)
+436 ;;=4^S34.9XXS
+437 ;;^UTILITY(U,$J,358.3,19345,2)
+438 ;;=^5025273
+439 ;;^UTILITY(U,$J,358.3,19346,0)
+440 ;;=S14.9XXS^^65^791^13
+441 ;;^UTILITY(U,$J,358.3,19346,1,0)
+442 ;;=^358.31IA^4^2
+443 ;;^UTILITY(U,$J,358.3,19346,1,3,0)
+444 ;;=3^Injury of unspec nerves of neck, sequela
+445 ;;^UTILITY(U,$J,358.3,19346,1,4,0)
+446 ;;=4^S14.9XXS
+447 ;;^UTILITY(U,$J,358.3,19346,2)
+448 ;;=^5022219
+449 ;;^UTILITY(U,$J,358.3,19347,0)
+450 ;;=S58.922S^^65^791^20
+451 ;;^UTILITY(U,$J,358.3,19347,1,0)
+452 ;;=^358.31IA^4^2
+453 ;;^UTILITY(U,$J,358.3,19347,1,3,0)
+454 ;;=3^Partial traumatic amp of l forearm, level unsp, sequela
+455 ;;^UTILITY(U,$J,358.3,19347,1,4,0)
+456 ;;=4^S58.922S
+457 ;;^UTILITY(U,$J,358.3,19347,2)
+458 ;;=^5031957
+459 ;;^UTILITY(U,$J,358.3,19348,0)
+460 ;;=S14.109S^^65^791^15
+461 ;;^UTILITY(U,$J,358.3,19348,1,0)
+462 ;;=^358.31IA^4^2
+463 ;;^UTILITY(U,$J,358.3,19348,1,3,0)
+464 ;;=3^Injury to unsp level of cervical spinal cord unspec, sequela
+465 ;;^UTILITY(U,$J,358.3,19348,1,4,0)
+466 ;;=4^S14.109S
+467 ;;^UTILITY(U,$J,358.3,19348,2)
+468 ;;=^5134243
+469 ;;^UTILITY(U,$J,358.3,19349,0)
+470 ;;=S24.109S^^65^791^17
+471 ;;^UTILITY(U,$J,358.3,19349,1,0)
+472 ;;=^358.31IA^4^2
+473 ;;^UTILITY(U,$J,358.3,19349,1,3,0)
+474 ;;=3^Injury to unsp level of thoracic spinal cord, sequela
+475 ;;^UTILITY(U,$J,358.3,19349,1,4,0)
+476 ;;=4^S24.109S
+477 ;;^UTILITY(U,$J,358.3,19349,2)
+478 ;;=^5134384
+479 ;;^UTILITY(U,$J,358.3,19350,0)
+480 ;;=S34.139S^^65^791^14
+481 ;;^UTILITY(U,$J,358.3,19350,1,0)
+482 ;;=^358.31IA^4^2
+483 ;;^UTILITY(U,$J,358.3,19350,1,3,0)
+484 ;;=3^Injury to sacral spinal cord, sequela
+485 ;;^UTILITY(U,$J,358.3,19350,1,4,0)
+486 ;;=4^S34.139S
+487 ;;^UTILITY(U,$J,358.3,19350,2)
+488 ;;=^5025249
+489 ;;^UTILITY(U,$J,358.3,19351,0)
+490 ;;=S34.109S^^65^791^16
+491 ;;^UTILITY(U,$J,358.3,19351,1,0)
+492 ;;=^358.31IA^4^2
+493 ;;^UTILITY(U,$J,358.3,19351,1,3,0)
+494 ;;=3^Injury to unsp level of lumbar spinal cord, sequela
+495 ;;^UTILITY(U,$J,358.3,19351,1,4,0)
+496 ;;=4^S34.109S
+497 ;;^UTILITY(U,$J,358.3,19351,2)
+498 ;;=^5134570
+499 ;;^UTILITY(U,$J,358.3,19352,0)
+500 ;;=S06.9X9S^^65^791^19
+501 ;;^UTILITY(U,$J,358.3,19352,1,0)
+502 ;;=^358.31IA^4^2
+503 ;;^UTILITY(U,$J,358.3,19352,1,3,0)
+504 ;;=3^Intracranial injury w LOC of unsp duration, sequela
+505 ;;^UTILITY(U,$J,358.3,19352,1,4,0)
+506 ;;=4^S06.9X9S
+507 ;;^UTILITY(U,$J,358.3,19352,2)
+508 ;;=^5021235
+509 ;;^UTILITY(U,$J,358.3,19353,0)
+510 ;;=S15.002A^^65^791^5
+511 ;;^UTILITY(U,$J,358.3,19353,1,0)
+512 ;;=^358.31IA^4^2
+513 ;;^UTILITY(U,$J,358.3,19353,1,3,0)
+514 ;;=3^Injury of left carotid artery, init encntr
+515 ;;^UTILITY(U,$J,358.3,19353,1,4,0)
+516 ;;=4^S15.002A
+517 ;;^UTILITY(U,$J,358.3,19353,2)
+518 ;;=^5022223
+519 ;;^UTILITY(U,$J,358.3,19354,0)
+520 ;;=S15.001A^^65^791^10
+521 ;;^UTILITY(U,$J,358.3,19354,1,0)
+522 ;;=^358.31IA^4^2
+523 ;;^UTILITY(U,$J,358.3,19354,1,3,0)
+524 ;;=3^Injury of right carotid artery, init encntr
+525 ;;^UTILITY(U,$J,358.3,19354,1,4,0)
+526 ;;=4^S15.001A
+527 ;;^UTILITY(U,$J,358.3,19354,2)
+528 ;;=^5022220
+529 ;;^UTILITY(U,$J,358.3,19355,0)
+530 ;;=I69.952^^65^792^12
+531 ;;^UTILITY(U,$J,358.3,19355,1,0)
+532 ;;=^358.31IA^4^2
+533 ;;^UTILITY(U,$J,358.3,19355,1,3,0)
+534 ;;=3^Hemiplagia,Left Dominant Side
+535 ;;^UTILITY(U,$J,358.3,19355,1,4,0)
+536 ;;=4^I69.952
+537 ;;^UTILITY(U,$J,358.3,19355,2)
+538 ;;=^5133586
+539 ;;^UTILITY(U,$J,358.3,19356,0)
+540 ;;=I69.954^^65^792^13
+541 ;;^UTILITY(U,$J,358.3,19356,1,0)
+542 ;;=^358.31IA^4^2
+543 ;;^UTILITY(U,$J,358.3,19356,1,3,0)
+544 ;;=3^Hemiplegia,Left Non-Dominant Side
+545 ;;^UTILITY(U,$J,358.3,19356,1,4,0)
+546 ;;=4^I69.954
+547 ;;^UTILITY(U,$J,358.3,19356,2)
+548 ;;=^5133587
+549 ;;^UTILITY(U,$J,358.3,19357,0)
+550 ;;=I69.951^^65^792^14
+551 ;;^UTILITY(U,$J,358.3,19357,1,0)
+552 ;;=^358.31IA^4^2
+553 ;;^UTILITY(U,$J,358.3,19357,1,3,0)
+554 ;;=3^Hemiplegia,Right Dominant Side
+555 ;;^UTILITY(U,$J,358.3,19357,1,4,0)
+556 ;;=4^I69.951
+557 ;;^UTILITY(U,$J,358.3,19357,2)
+558 ;;=^5007561
+559 ;;^UTILITY(U,$J,358.3,19358,0)
+560 ;;=I69.953^^65^792^15
+561 ;;^UTILITY(U,$J,358.3,19358,1,0)
+562 ;;=^358.31IA^4^2
+563 ;;^UTILITY(U,$J,358.3,19358,1,3,0)
+564 ;;=3^Hemiplegia,Right Non-Dominant Side
+565 ;;^UTILITY(U,$J,358.3,19358,1,4,0)
+566 ;;=4^I69.953
+567 ;;^UTILITY(U,$J,358.3,19358,2)
+568 ;;=^5007562
+569 ;;^UTILITY(U,$J,358.3,19359,0)
+570 ;;=I69.920^^65^792^1
+571 ;;^UTILITY(U,$J,358.3,19359,1,0)
+572 ;;=^358.31IA^4^2
+573 ;;^UTILITY(U,$J,358.3,19359,1,3,0)
+574 ;;=3^Aphasia
+575 ;;^UTILITY(U,$J,358.3,19359,1,4,0)
+576 ;;=4^I69.920
+577 ;;^UTILITY(U,$J,358.3,19359,2)
+578 ;;=^5007553
+579 ;;^UTILITY(U,$J,358.3,19360,0)
+580 ;;=I69.90^^65^792^30
+581 ;;^UTILITY(U,$J,358.3,19360,1,0)
+582 ;;=^358.31IA^4^2
+583 ;;^UTILITY(U,$J,358.3,19360,1,3,0)
+584 ;;=3^Unspec Sequela of Unspec CVA
+585 ;;^UTILITY(U,$J,358.3,19360,1,4,0)
+586 ;;=4^I69.90
+587 ;;^UTILITY(U,$J,358.3,19360,2)
+588 ;;=^5007551
+589 ;;^UTILITY(U,$J,358.3,19361,0)
+590 ;;=I69.910^^65^792^4
+591 ;;^UTILITY(U,$J,358.3,19361,1,0)
+592 ;;=^358.31IA^4^2
+593 ;;^UTILITY(U,$J,358.3,19361,1,3,0)
+594 ;;=3^Attention & Concentration Deficit
+595 ;;^UTILITY(U,$J,358.3,19361,1,4,0)
+596 ;;=4^I69.910
+597 ;;^UTILITY(U,$J,358.3,19361,2)
+598 ;;=^5138660
+599 ;;^UTILITY(U,$J,358.3,19362,0)
+600 ;;=I69.911^^65^792^16
+601 ;;^UTILITY(U,$J,358.3,19362,1,0)
+602 ;;=^358.31IA^4^2
+603 ;;^UTILITY(U,$J,358.3,19362,1,3,0)
+604 ;;=3^Memory Deficit
+605 ;;^UTILITY(U,$J,358.3,19362,1,4,0)
+606 ;;=4^I69.911
+607 ;;^UTILITY(U,$J,358.3,19362,2)
+608 ;;=^5138661
+609 ;;^UTILITY(U,$J,358.3,19363,0)
+610 ;;=I69.912^^65^792^31
+611 ;;^UTILITY(U,$J,358.3,19363,1,0)
+612 ;;=^358.31IA^4^2
+613 ;;^UTILITY(U,$J,358.3,19363,1,3,0)
+614 ;;=3^Visuspatial Deficit & Spatial Neglect
+615 ;;^UTILITY(U,$J,358.3,19363,1,4,0)
+616 ;;=4^I69.912
+617 ;;^UTILITY(U,$J,358.3,19363,2)
+618 ;;=^5138662
+619 ;;^UTILITY(U,$J,358.3,19364,0)
+620 ;;=I69.913^^65^792^27
+621 ;;^UTILITY(U,$J,358.3,19364,1,0)
+622 ;;=^358.31IA^4^2
+623 ;;^UTILITY(U,$J,358.3,19364,1,3,0)
+624 ;;=3^Psychomotor Deficit
+625 ;;^UTILITY(U,$J,358.3,19364,1,4,0)
+626 ;;=4^I69.913
+627 ;;^UTILITY(U,$J,358.3,19364,2)
+628 ;;=^5138663
+629 ;;^UTILITY(U,$J,358.3,19365,0)
+630 ;;=I69.914^^65^792^11
+631 ;;^UTILITY(U,$J,358.3,19365,1,0)
+632 ;;=^358.31IA^4^2
+633 ;;^UTILITY(U,$J,358.3,19365,1,3,0)
+634 ;;=3^Frontal Lobe & Executive Function Deficit
+635 ;;^UTILITY(U,$J,358.3,19365,1,4,0)
+636 ;;=4^I69.914
+637 ;;^UTILITY(U,$J,358.3,19365,2)
+638 ;;=^5138664
+639 ;;^UTILITY(U,$J,358.3,19366,0)
+640 ;;=I69.915^^65^792^5
+641 ;;^UTILITY(U,$J,358.3,19366,1,0)
+642 ;;=^358.31IA^4^2
+643 ;;^UTILITY(U,$J,358.3,19366,1,3,0)
+644 ;;=3^Cognitive Social/Emotional Deficit
+645 ;;^UTILITY(U,$J,358.3,19366,1,4,0)
+646 ;;=4^I69.915
+647 ;;^UTILITY(U,$J,358.3,19366,2)
+648 ;;=^5138665
